Reducing the length of the conchal bowl and antihelix cartilage for a smaller ear.
Reduction of the ear requires addressing the enlarged components. In this case the conchal bowl was very big, but so were other elements. Making an ear smaller must consider the blood supply to keep tissues alive resulting in compromise. Tissues can only be pushed so far. Selection of what a specific reduction requires is part of Dr. Bermant's skill as a surgical sculpture. This patient's conchal bowl was very large, but so were also other elements of the ear. The wedge resection from the middle of the ear permits access to the helix rim, anthelix, and concha. Elevation of the helix rim scar is hidden except across the fleshy edge of the ear. The scar along the anthelix and conchal floor can be visible.
The following pictures on this page are graphic in nature. Please skip if explicit surgical details bother you.
Reduction of the Concha Bowl and Antihelix reduces the legnth of these structures and the ear in general.
This patient's concha bowl and anthelix were big and sculpture permited a balanced ear reduction.
|Picture of wedge of cartilage and skin from concha bowl and antihelix initial reduction for macrotia|
|Picture of testing the height of the ear after the initial reduction. Dr. Bermant removed 10 mm of cartilage initially.|
The complex shape of the ear forces a careful three dimensional sculpture of the concha and anthelix cartilage during otoplasty. Easy to remove, cartilage is hard to replace.
|Trimming another 2 mm of cartilage from the antihelix and concha for adequate reduction picture during surgery.|
|Measuring again to see if enough has been removed. The ear will be made smaller removing tissue from the scapha|
This is not just a simple excision of a triangle wedge of tissue. Dr. Bermant adjusts how much cartilage is removed deep in the concha vs. more superficially from the antihelix. How much taken from each part can change the position of the different components bringing the top and bottom of the ear closer or further away from the head. Sometimes the patient will need suture sculpture behind the ears balancing the distance of the various ear elements from the head.
To view before and after pictures of this patient, start here.
|Photographs During Ear Reduction Surgery|
|Helix Rim Flap Elevation||Reduce Concha and Antihelix||Sculpture Concha and Antihelix||Reduce Scaphoid Fossa||Reduce Helix Rim & Auricle||Macrotia Earlobe Setback|
(Warning graphic images.)
(Warning graphic images.)